Crnjaković-Palmović Jasenka, Jeren-Strujić Branka, Gudel-Gregurić Jasna, Bozić Borka, Palmović Dragan
Centar za hemodijalizu, Klinicka bolnica Dubrava, Zagreb, Hrvatska, Croatia.
Acta Med Croatica. 2005;59(2):113-6.
AIM, PATIENTS AND METHODS: The high prevalence of anti-hepatitis C virus antibodies (anti-HCV) in hemodialyzed (HD) patients has been recognized since the early 1990s. Over the last decade, a significant decrease of anti-HCV prevalence among HD patients has been observed in many west European countries. In order to evaluate whether this trend is also present in Dialysis Center of Dubrava University Hospital, Zagreb, we tested HD patients for anti-HCV and HCV RNA in serum. ELISA 3 (Sorin) was used as a screening anti-HCV test, and confirmatory testing relied on western blotting (BioRad). HCV RNA was tested by HCV RNA PCR (Roche) and AMPLICOR, HCV test, version 2.0 (Roche).
The low prevalence of HCV infection is a consequence of the screening of blood donors with increasingly sensitive anti-HCV tests, followed by the progressive reduction of blood transfusion due to the availability of erythropoietin and the reinforcement of universral hygienic precautions and strict infection control in our HD unit. A contributing factor was the prevention of nosocomial transmission by the separation of anti-HCV positive from anti-HCV negative patients. Thus, the low prevalence of HCV infection in our HD center contributes-to an improved prognosis in end stage renal disease patients by additionally reducing the risk of nosocomial HCV infection.
目的、患者与方法：自20世纪90年代初以来，血液透析（HD）患者中抗丙型肝炎病毒抗体（抗-HCV）的高流行率已为人所知。在过去十年中，许多西欧国家的HD患者中抗-HCV流行率显著下降。为了评估萨格勒布杜布拉瓦大学医院透析中心是否也存在这种趋势，我们检测了HD患者血清中的抗-HCV和HCV RNA。采用酶联免疫吸附试验3（索林公司）作为抗-HCV筛查试验，确证试验采用蛋白质印迹法（伯乐公司）。通过HCV RNA聚合酶链反应（罗氏公司）和AMPLICOR HCV检测试剂盒2.0版（罗氏公司）检测HCV RNA。
HCV感染低流行率是由于使用越来越敏感的抗-HCV检测对献血者进行筛查，随后由于促红细胞生成素的可得性以及我们HD科室加强了普遍卫生预防措施和严格的感染控制，输血逐渐减少。一个促成因素是通过将抗-HCV阳性患者与抗-HCV阴性患者分开来预防医院内传播。因此，我们HD中心HCV感染的低流行率通过额外降低医院内HCV感染风险，有助于改善终末期肾病患者的预后。
